Community PMTCT Challenges: Operational Issues in Testing Pregnant Women Without ANC Through CBOs Versus the ANC and Testing Model in Congregation Settings
DOI:
https://doi.org/10.14738/bjhr.1204.19207Keywords:
Community, PMTCT, challenges, testing Model, congregation settingsAbstract
This paper examines operational challenges in implementing two community-based Prevention of Mother-to-Child Transmission (PMTCT) of HIV approaches in Northern Nigeria: testing pregnant women without antenatal care (ANC) through community-based organizations (CBOs) and the ANC and Testing Model in congregation settings (Tabbatacciyar Kulawar Iyali). Based on implementation experiences from the Accelerating Control of HIV Epidemic in Nigeria - Cluster 2 (ACE 2) project, we analyze operational issues including access, training, data management, and comparative effectiveness. The congregation-based approach demonstrated higher yield in identifying HIV-positive pregnant women despite challenges (Gobir et al., 2025). We provide recommendations for strengthening both approaches to reach pregnant women who do not access conventional healthcare services.
References
Aarons, G. A., Hurlburt, M., & Horwitz, S. M. C. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4-23. https://doi.org/10.1007/s10488-010-0327-7
Abiodun, O., Omotayo, A. R., Oluwasanu, M. M., & Ajuwon, A. J. (2022). Why is mother to child transmission (MTCT) of HIV a continual threat to new-borns in sub-Saharan Africa (SSA). Science Direct. https://www.sciencedirect.com/science/article/pii/S187603411830176X
Chi, B. H., Mbori-Ngacha, D., Essajee, S., Mofenson, L. M., Tsiouris, F., Mahy, M., Stankard, P., Penazzato, M., Aly, D., Welty, T., Muhe, L., Matida, L., Samba, M. C., Mandala, J., & Abrams, E. J. (2020). Accelerating progress towards the elimination of mother-to-child transmission of HIV: A narrative review. Journal of the International AIDS Society, 23(8), Article e25571. https://doi.org/10.1002/jia2.25571
Ezeanolue, E. E., Obiefune, M. C., Ezeanolue, C. O., Ehiri, J. E., Osuji, A., Ogidi, A. G., Hunt, A. T., Patel, D., Yang, W., Pharr, J., & Ogedegbe, G. (2015). Effect of a congregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (Baby Shower): A cluster randomised trial. The Lancet Global Health, 3(11), e692-e700. https://doi.org/10.1016/S2214-109X(15)00195-3
Ezeanolue, E. E., Obiefune, M. C., Yang, W., Obaro, S. K., Ezeanolue, C. O., & Ogedegbe, G. G. (2013). Comparative effectiveness of congregation- versus clinic-based approach to prevention of mother-to-child HIV transmission: Study protocol for a cluster randomized controlled trial. Implementation Science, 8(1), Article 62. https://doi.org/10.1186/1748-5908-8-62
Gobir, I. B., Niyang, M., Zubayr, B., Moses, B. M., et al., (2025). Tabbatacciyar Kulawar Iyali: Adaptation of the Baby Shower Congregation-based Intervention for Maternal HIV Testing in Predominantly Muslim Communities in Nigeria. British Journal of Healthcare and Medical Research, 12(2), 383-397. https://doi.org/10.14738/bjhr.1202.18697
Gunn, J. K. L., Asaolu, I. O., Center, K. E., Gibson, S. J., Wightman, P., Ezeanolue, E. E., & Ehiri, J. E. (2016). Antenatal care and uptake of HIV testing among pregnant women in sub-Saharan Africa: A cross-sectional 262 study. Journal of the International AIDS Society, 19(1), Article 20605. https://doi.org/10.7448/IAS.19.1.20605
Ikpeazu, A. E., Anya, S. E., Amenyah, R. N., Ijaodola, O. A., Bashorun, A. T., Ndukwe, C. D., Davies, A., Mobolaji-Bello, M., Ukanwa, C., Anosike, A. O., Daniel, U., Ogbang, D. A., Takpa, K. V., Ojo, O. A., Ogorry, O., Akpu, M., Ashefor, G., Ogundipe, A., Aliyu, G. G., & Morah, E. (2023). An analysis of the uptake of anti-retroviral treatment among pregnant women in Nigeria from 2015 to 2020. PLOS global public health, 3(4), e0001749. https://doi.org/10.1371/journal.pgph.0001749
Kadye, T., Jamil, M. S., Johnson, C., Baggaley, R., Barr-Dichiara, M., & Cambiano, V. (2024). Country uptake of WHO recommendations on differentiated HIV testing services approaches: A global policy review. BMJ Open, 14(3), Article e077413. https://pubmed.ncbi.nlm.nih.gov/38485173/
Marcos, Y., Phelps, B. R., & Bachman, G. (2012). Community strategies that improve care and retention along the prevention of mother-to-child transmission of HIV cascade: A review. Journal of the International AIDS Society, 15(Suppl 2), Article 17394. https://doi.org/10.7448/IAS.15.4.17394
Montandon, M., Efuntoye, T., Itanyi, I. U., Onoka, C. A., Onwuchekwa, C., Gwamna, J., Ameh, P. O., Okonkwo, P., Ndem, P., Ezeanolue, E. E., Adegoke, O., & Aguirre, A. (2021). Improving uptake of prevention of mother-tochild HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy. PLoS One, 16(12), Article e0260694. https://doi.org/10.1371/journal.pone.0260694
Moullin, J. C., Dickson, K. S., Stadnick, N. A., Rabin, B., & Aarons, G. A. (2019). Systematic review of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Implementation Science, 14(1), Article 1. https://doi.org/10.1186/s13012-018-0842-6
National Agency for the Control of AIDS. (2021). Modes of HIV transmission in Nigeria: Application of the incidence patterns model 2020. Abuja, Nigeria: Author.
National Population Commission & ICF. (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: Author.
Olakunde, B. O., Adeyinka, D. A., Olawepo, J. O., Pharr, J. R., Ozigbu, C. E., Wakdok, S., Stafford, K. A., & Ezeanolue, E. E. (2019). Towards the elimination of mother-to-child transmission of HIV in Nigeria: A health system perspective of the achievements and challenges. International Health, 11(4), 240-249. https://doi.org/10.1093/inthealth/ihz018
UNAIDS. (2023). The Urgency of Now: AIDS at a Crossroads. Joint United Nations Programme on HIV/AIDS. Geneva, Switzerland: Author.
UNAIDS. (2024). UNAIDS Data 2024. Joint United Nations Programme on HIV/AIDS. Geneva, Switzerland: Author.
UNICEF. (2024). Elimination of mother-to-child transmission. UNICEF DATA. https://data.unicef.org/topic/hivaids/emtct/
World Health Organization (WHO). (2020). Mother-to-child transmission of HIV. https://www.who.int/hiv/topics/mtct/en/
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Copyright (c) 2025 Aramide Apo-Oyin, Itunu Omolade Dave-Agboola, Bridget Okosa, Joy Musa Shallangwa, Piringar Mercy Niyang, Ibrahim Bola Gobir

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